Cal protectin test result

[Cronie1]

Hi everyone.

I was hoping for some advice, I was on budesonide for 3 months and tapered off around a month ago. Whilst on the medication my cal protectin was 28, a remarkable improvement as before medication it was 1389. From coming off the budesonide, I have felt some symptoms returning. I just received the result of my most recent cal protectin after coming off the drug, which was 185. In your opinion is this normal ? or do you think I will need to go onto other maintenance medication? I believe my consultant was considering azathioprine. Just not sure what the normal range is.

Many thanks

 

[Clash]

The normal reference range (NNR) varies by lab. For some labs >50 is normal and for others >167.

But when monitoring your disease activity trends are important. If you are experiencing symptoms and your FC result is trending upward then the GI may want to put you on some type of med. Most patients require a maintenance med like azathioprine, 6mp, methotrexate or one of the biologics.

 

[Guerrero]

Azathioprine would be helpfull to let things under control but it can take nonths to be effective.
You definitely need a maintenance therapy outside steroids, could be aza or biologics as Clash said

 

[Cronie1]

Thank you both for your responses. I was naively optimistic, hoping that after the budesonide I would not need any medication, but I suppose I should not be surprised, and it could always be a lot worse. Thanks again for your insight.

 

[Guerrero]

185 is not that high though, so dont worry

 

[Cronie1]

Hi again,

Eventually got confirmation from my consultant and he wants me to go on the 50mg of Azathioprine. Had mentioned to him also that we were hoping to start a family in the near future, but obviously that didn't change his thoughts. Feeling worried right now.

 

[Guerrero]

Hi Cronie1,

I had been on azathioprine for many many years and it worked very well without side effects.
You'll probably need to do blood tests every 2/3 months, and that's it.

Not sure it's even a big issue for pregnancy, you'll have to discuss with your doctor probably.

 

[Cronie1]

Hi Guerrero

I hope it works as good for me, thanks for your reassurance. :cheers:

 

[Cronie1]

Hi again,

I just started the azathioprine on Friday, and was hoping for some advice with it; on the first day I had no side effects, but yesterday I felt nausea, had bad heartburn/acid reflux which I took omeprazole for, dizzness and was blacking out when standing up. Later in the evening I Had a new pain high up in my abdomen mostly on the left side, quite bad so that it was sore to move. The pain later radiated through to my back/shoulder blade. Pain has eased a bit, but still feeling tender

Should I continue to take the azathioprine today with these side effects? I have no one else to ask, other than going to A&E. :sign0085

 

[Guerrero]

Are you sure those are side effects from azathioprine and not from something you eat or something else?

Best thing would be to report it to your GI. Personally if pain and nausea is not too much i'd stick to it, but still i'd ask to a doctor too.

How many mg/day are you starting with?

 

[Cronie1]

I can cope with the nausea and even the dizziness but the stomach pain worried me. It was pretty bad. I'll maybe try and contact about of hours doctor today, but in my past experience they are reluctant to advise. I am starting off on 50mg.

 

[Guerrero]

Ok so it's probably the lowest dose to start with.
I been experiencing nausea too these last weeks,and ginger infusions and supplements helped me a lot.
Hope you feel better soon. Let us know

 

[Cronie1]

Just got a call from the doctor, he advised to stop taking it and to see my g.p for a lower dose of 25mg. So glad I don't have to take it today...

 

[Jabee]

Make sure you get your pancreatic enzymes checked when you see your GP. Azathioprine and its sister drug mercaptopurine (6MP) cause pancreatitis in some people.

 

[Cronie1]

Will do Jabee, thanks for the tip. It's certainly a 'new' pain for me.